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HME Expo preview: Overcoming 'fear' of ABNs

The following is the first in a series of Q&As with speakers who will present at the inaugural HME Exposition & Conference, April 21-23, in Baltimore. To register for the event, go to www.hmeexpo.com

BALTIMORE - Although it has the potential to boost HME cash sales, the Medicare advanced beneficiary notice (ABN) has gone largely unused by providers. The reason, according to billing specialist Jane Wilkinson-Bunch: Providers don't know how it's used or completed. Yet there's a simple solution for ABN trepidation, she says. Bunch will discuss that solution during her session, "Is the ABN in your survival kit? It should be," at the HME Exposition & Conference, April 21-23, in Baltimore.

HME News: Why have too few providers embraced ABNs? What are the obstacles they face and how can they overcome them?

Jane Bunch: Providers are actually scared or worried about using ABNs because CMS has stated so many times that ABNs should not be "routinely used" and providers do not seem to know how to properly use them. They need to educate themselves on how to use ABNs within their corporate structure for upgrades and for medical necessity reasons. You have to protect yourself--and patients have the right to get the Cadillac over the Yugo.

HME: Will more providers begin using ABNs with a 9.5% nationwide reimbursement cut and a 36-month cap on Medicare oxygen reimbursement?

Bunch: Providers will be using ABNs more than ever before in 2009/2010. I am receiving numerous calls from providers on how to use ABNs appropriately. They are beginning to understand that we all have to become better business people to stay in business and grow as we should. With the 36-month cap, providers do not yet understand the reimbursement following the cap and will use ABNs for things not covered or when patients want more than what Medicare is going to cover.

HME: Why should providers use ABNs?

Bunch: Because it's good business. Protect yourself and collect the money from that beneficiary to upgrade items to a higher quality that Medicare does not cover. Patients today understand Medicare and their insurance better than ever. They want to pay to get the best. If you are going to be sick and need medical equipment, why not upgrade to the one with diamonds and studs?

HME: If providers take away one piece of advice from your session, what would it be?

Bunch: It is okay to use ABNs within your corporate structure. Train and educate your staff on what you have learned and when you can use ABNs. If they understand the proper use, they will have the ability to discuss potential upgrades with the patient, as well as understand when to use them for lack of medical necessity. It will increase revenue within your company and offset the many losses we have been so kindly given this year.